scholarly journals Study of polymorphisms of UGT1A1 and DPYD genes in chemotherapy for colorectal cancer

2019 ◽  
Vol 17 (6) ◽  
pp. 49-56
Author(s):  
N. N. Timoshkina ◽  
O. A. Bogomolova ◽  
I. A. Zhuzhelenko ◽  
S. N. Kabanov ◽  
E. A. Kalabanova ◽  
...  
Keyword(s):  
Side Effects ◽  
Venous Blood ◽  
Significant Proportion ◽  
Circulatory System ◽  
Individual Choice ◽  
Dpyd Gene ◽  
Preliminary Examination ◽  
Caucasian Patients ◽  
Personalized Approach ◽  
Toxic Reactions

Background. The personalized approach implies an individual choice of medicines and their doses for the patient, providing the most effective and safe pharmacotherapy. Objective: analysis of the frequencies of UGT1A1 and DPYD polymorphisms and comparison of genotyping data with irinotecan and 5-fluorouracil-induced toxicity, respectively.Materials and Methods. Venous blood of 94 Caucasian patients (46 men and 48 women, median age 61 years). The *6 and *28 UGT1A1 alleles were identified by pyrosequencing, and the *2А DPYD allele was identified by Real-time PCR.Results. The genotyping of 94 patients with colon cancer did not reveal the *2A SNP in the DPYD gene. The frequency rate of the *6 and *28 alleles of the UGT1A1 gene was 0.346 and 0.016, respectively. 24 % of patients receiving chemotherapy with 5-fluorouracil developed side effects associated with the circulatory system and the gastrointestinal tract. Hematological and nonhematological toxic reactions were noted in 48 % and 50 % of patients receiving irinotecan. Severe bilirubinemia was associated with the *28/*28 UGT1A1 genotype. The presence of a high-risk genotype (*28/*1, *28/*28 UGT1A1) correlated with the development of side effects (p=0.040).Conclusion. The absence of carriers of the *2А DPYD allele in the sample with a significant proportion of pronounced adverse toxic reactions to 5-fluorouracil causes the need for the inclusion of new polymorphisms of the DPYD gene in pharmacogenetic testing. The inclusion of genotyping of UGT1A1 polymorphisms into a complex of preliminary examination is advisable when planning treatment with irinotecan.

DPYD gene polymorphisms in patients with gastrointestinal tumors receiving chemotherapy with 5-fluorouracil.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 90-90
Author(s):  
Oleg Ivanovich Kit ◽  
Liubov Yu Vladimirova ◽  
Natalya N. Timoshkina ◽  
Anna E. Storozhakova ◽  
Natalia A. Petrusenko ◽  
...  
Keyword(s):  
Direct Sequencing ◽  
Venous Blood ◽  
Gastrointestinal Tumors ◽  
Hematological Toxicity ◽  
Malignant Neoplasms ◽  
Inclusion Criteria ◽  
Dpyd Gene ◽  
Caucasian Patients ◽  
Partial Deficiency ◽  
Caucasoid Population

90 Background: Complete or partial deficiency of the DPD enzyme due to genetic polymorphisms of the DPYD gene causes acute toxicity of fluoropyrimidines, which are widely used in combination chemotherapy regimens for various malignant neoplasms. The purpose of the study: to identify polymorphisms of the DPYD gene significant for 5-fluorouracil-induced toxicity. Methods: Venous blood samples from Caucasian patients were used to identify alleles of *2А rs3918290, 5* rs1801159, *13 rs55886062 and rs67376798 DPYD by RT-PCR and direct sequencing. Inclusion criteria were: verified diagnosis of gastrointestinal tumors, age>18 years old, fluoropyrimidine-containing regimes of treatment. Results: 104 pts were included, 54% were female. Mean age-61 years. Colorectal cancer was found in 80.7% pts, non-colorectal in 19.3% pts. Hematological and non-hematological toxicity Gd.3-4 was found in 24% pts. Allele * 5rs18011595, which causes enzyme deficiency was found in 28% of patients, (frequency was 0.281) which is significantly higher than the population frequency of the allele charactering for Caucasoid population (p <0.05). Meanwhile genotyping did not reveal the *2A, *13 alleles and rs67376798 alleles in the DPYD gene. Conclusions: *5rs1801159 allele was found as the main DPYD polymorphism associated with fluoropyrimidine toxicity in Caucasian pts with gastrointestinal tumors.

Graves'-Basedow disease in pregnancy

2015 ◽  
Vol 54 (03) ◽  
pp. 106-111 ◽  
Author(s):  
S. L. Andersen ◽  
P. Laurberg
Keyword(s):  
Side Effects ◽  
Birth Defects ◽  
Thyroid Dysfunction ◽  
National Study ◽  
Antithyroid Drugs ◽  
Upper Limit ◽  
Special Concern ◽  
Maternal Thyroid ◽  
Toxic Reactions ◽  
Serum Tsh

SummaryThyroid hormones are essential development factors and maternal thyroid dysfunction may cause pregnancy complications and diseases in the fetus/child. In the present review we discuss new data on the incidence of Graves'-Basedow disease (GBD) in and around pregnancy, and how hyperthyroidism may affect the risk of spontaneous abortion and stillbirth.A special concern in pregnant women is the potential side effects from the use of antithyroid drugs (ATDs). One type of side effects is the allergic/toxic reactions to the drugs, which seem to be similar in and outside pregnancy, and another is that ATDs tend to over treat the fetus when the mother with GBD is made euthyroid. To avoid fetal hypothyroidism, the lowest possible ATD dose should be used to keep maternal thyroid function at the upper limit of normality with low serum TSH. Birth defects after the use of methimazole (MMI) (or its prodrug carbimazole) have been considered to be very rare, and no risk has previously been associated with the use of propylthiouracil (PTU). However, a recent Danish national study found that 1/30 of children exposed to MMI in early pregnancy had birth defects associated with this, and many defects were severe. PTU exposure was associated with defects in 1/40, and these defects were less severe. Proposals are given on how to reduce the risk of ATD associated birth defects.

scholarly journals TNF-Alpha Inhibitors for Chronic Urticaria: Experience in 20 Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Freja Lærke Sand ◽  
Simon Francis Thomsen
Keyword(s):  
Side Effects ◽  
Chronic Urticaria ◽  
Treatment Options ◽  
Significant Proportion ◽  
Response Duration ◽  
Immunosuppressive Drugs ◽  
Tnf Alpha ◽  
High Dose ◽  
Duration Of Treatment ◽  
Durable Response

Patients with severe chronic urticaria may not respond to antihistamines, and other systemic treatment options may either be ineffective or associated with unacceptable side effects. We present data on efficacy and safety of adalimumab and etanercept in 20 adult patients with chronic urticaria. Twelve (60%) patients obtained complete or almost complete resolution of urticaria after onset of therapy with either adalimumab or etanercept. Further three patients (15%) experienced partial response. Duration of treatment ranged between 2 and 39 months. Those responding completely or almost completely had a durable response with a mean of 11 months. Six patients (30%) experienced side effects and five patients had mild recurrent upper respiratory infections, whereas one patient experienced severe CNS toxicity that could be related to treatment with TNF-alpha inhibitor. Adalimumab and etanercept may be effective and relatively safe treatment options in a significant proportion of patients with chronic urticaria who do not respond sufficiently to high-dose antihistamines or in whom standard immunosuppressive drugs are ineffective or associated with unacceptable side effects.

scholarly journals AB0267 HOW EFFECTIVE IS PAIN MANAGEMENT IN THE PATIENTS’ OPINION? DATA FROM THE COMPAS STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1160.1-1160
Author(s):  
E. Pogozheva ◽  
A. Karateev ◽  
V. Amirdzhanova
Keyword(s):  
Pain Management ◽  
Pain Therapy ◽  
Significant Proportion ◽  
Connective Tissue Diseases ◽  
Underlying Disease ◽  
Additional Treatment ◽  
Results Of Treatment ◽  
Analgesic Therapy ◽  
Folk Remedies ◽  
Personalized Approach

Objectives:to evaluate the effectiveness and satisfaction of pain management in patients with rheumatic diseases (RD) according to a survey in the COMPAS (Quality of Pain Management according to Patients with Arthritis and Back pain) study.Methods:the survey involved 1040 patients with RD (rheumatoid arthritis-40.6%, osteoarthritis -32.1%, spondyloarthritis-10.6%, connective tissue diseases-8.6% of patients). 76.8% were women, the mean age was 55.8±14.0 years. 35.7% of patients continued to work in their specialty, 31.6% had various degrees of disability. The effectiveness of pain therapy was evaluated by the patient in the last month preceding the survey on a 5-point scale, where 1 - no effect and 5-excellent effect. Patients ‘ satisfaction with treatment, possible reasons for the lack of effectiveness of pain therapy and the use of additional treatment tools were also evaluated.Results:as therapy for the underlying disease, 40% of patients received conventional disease modifying antirheumatic drugs, 33.1% - glucocorticoids, 7.2% - biological agents and 15.2% - symptomatic slow-acting drugs in osteoarthritis. At the same time, 68% of patients needed additional analgesic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). Slightly less than half of the surveyed patients (46.9%) noted a moderate effect of analgesic therapy, 22.7% - a low effect and 5% - no effect, 23.7% rated the effectiveness of therapy as good and only 1.7% - as excellent. At the same time, only 15.6% of patients were completely satisfied with the result of NSAIDs, 64% were partially satisfied with the treatment and 20.4% were completely dissatisfied. As the reason of insufficient effectiveness of NSAIDs, most often (34.3%) patients named fear of adverse events associated with taking drugs, 19.4% - weak drugs, 15.3% - insufficient attention of doctors to complaints, 6.6% - poor diagnosis of the causes of pain. Others found it difficult to answer or were completely satisfied with the treatment. 40% of patients used additional methods, most often chiropractic (12.3%), acupuncture (4.8%), physiotherapy (12.7%) and folk remedies (7.4%).Conclusion:A significant proportion of patients with RD don’t have adequate pain control. Only 25.4% of patients rate the result of treatment as good and excellent, and even fewer patients (15.6%) are completely satisfied with the results of therapy. Thus, a personalized approach to analgesic therapy is necessary, taking into account the expectations of patients regarding the results of treatment.Disclosure of Interests:None declared

scholarly journals The speed of reinfusion affects the vascular system during ozone major autohemotherapy

Ozone Therapy ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. 56 ◽  
Author(s):  
Daniele Rimini ◽  
Filippo Molinari ◽  
William Liboni ◽  
Vincenzo Simonetti ◽  
Marianno Franzini
Keyword(s):  
Infrared Spectroscopy ◽  
Side Effects ◽  
Near Infrared Spectroscopy ◽  
Transcranial Doppler ◽  
Near Infrared ◽  
Vascular System ◽  
Venous Blood ◽  
Blood Drawing

Ozone major autohemotherapy (O-MAHT) is a way of ozonetherapy administration consisting of drawing patient’s venous blood, mixing with oxygen/ozone, and reinfusing it into the vein. Some ozone therapists reported side effects during the O-MAHT, but the origin has not been described yet. We investigated the effect of blood drawing velocity during O-MAHT to see its effects on the vascular system and symptomatology. We administered O-MAHT to 11 subjects, and we interleaved fast and slow reinfusions. We monitored cerebral macrocirculation with transcranial Doppler (TCD) and tissue microcirculation with near-infrared spectroscopy (NIRS). Annoying symptoms appeared just during the fast reinfusion periods. NIRS and TCD parameters revealed vasoconstriction during fast reinfusion and improved metabolism during slow reinfusion. Overall, our investigation well discriminated fast from slow reinfusion velocity.

scholarly journals Can Homeopathy, a Particularly Mild Therapeutic Approach, Survive and Grow in a World of Violence?

Homeopathy ◽  
2020 ◽  
Vol 109 (03) ◽  
pp. 179-181 ◽  
Author(s):  
George Vithoulkas
Keyword(s):  
Side Effects ◽  
Therapeutic Approach ◽  
Modern World ◽  
Contemporary Society ◽  
Philosophical Question ◽  
Therapeutic System ◽  
Personalized Approach ◽  
Positive Results ◽  
Clinical Problems

AbstractThis short treatise addresses a philosophical question concerning the place of homeopathy in our modern world. The question raised is whether a therapeutic system as peaceful, mild, and non-violent as homeopathy can survive and grow within a society that often displays the opposite characteristics.Much of contemporary society is more interested in fast and impressive cures, even if these may also bring side effects; whereas homeopathy can offer solutions with a personalized approach that requires long hours of case study by the homeopath to find the correct personal remedy that aims to bring about positive results, which the therapy can produce in deep chronic diseases.The conclusion drawn is that homeopathy does not readily fit within a modern and violent society that prefers quick and invasive solutions to its clinical problems.

scholarly journals Knowledge and Attitude of Nursing Students toward Electroconvulsive Therapy

2017 ◽  
Vol 08 (S 01) ◽  
pp. S007-S012 ◽  
Author(s):  
Nitasha Sharma ◽  
Sandhya Ghai ◽  
Sandeep Grover
Keyword(s):  
Nursing Students ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Mechanism Of Action ◽  
Significant Proportion ◽  
Negative Attitude ◽  
Treatment Modalities ◽  
Attitude Score ◽  
Negative Attitudes ◽  
Knowledge And Attitude

ABSTRACT Background: Electroconvulsive therapy (ECT) is one of the commonly used treatment modalities for patients with severe mental disorders. However, acceptance of ECT by the patient and relatives often depends on how the health-care professionals themselves present the treatment modality to the patients and their relatives. There is a lack of information about the knowledge and attitude toward ECT among health professionals. Aim: This study aimed to evaluate the knowledge about and attitude toward ECT among nursing students. Methodology: Knowledge of and attitudes toward ECT among nursing students were assessed using ECT knowledge and attitude questionnaires. Results: The study included 183 nursing students. Majority (n = 62; 60.8%) of the participants obtained information about ECT from media (movies, television, print media, etc.). None of the students had full knowledge about ECT. Although a significant proportion of students had knowledge about the ECT procedure and consent procedure, majority of them had poor knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitudes were also highly prevalent, with more than two-thirds of the participants having negative attitudes toward ECT on more than half of the attitude items of the scale. Total knowledge score positively correlated with total attitude score, suggesting that higher knowledge was associated with more positive attitude. Conclusions: Although nursing students have knowledge about basic ECT procedure and consent, they lack knowledge about the effectiveness, mechanism of action, indications, and side effects of ECT. Negative attitude toward ECT is also highly prevalent among nursing students. Accordingly, there is a need to improve the knowledge and address the negative attitude of nursing students, which may ultimately lead to better acceptance of the treatment.

scholarly journals Strategies for improving the management of immune-related adverse events

2020 ◽  
Vol 8 (2) ◽  
pp. e001754
Author(s):  
Aung Naing ◽  
Joud Hajjar ◽  
James L Gulley ◽  
Michael B Atkins ◽  
Gennaro Ciliberto ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Checkpoint Inhibitors ◽  
Digital Health ◽  
Immunosuppressive Agents ◽  
Significant Proportion ◽  
Cell Activity ◽  
Predictive Biomarkers ◽  
Chemotherapeutic Agents ◽  
Diagnostic Tools

With the advent of immunotherapeutic agents, durable and dramatic responses have been observed in several hard-to-treat malignancies, outlining a roadmap to conquering cancer. Immune checkpoint inhibitors (ICPi) are a class of immunotherapeutic agents that attack the tumor cells by reinvigorating the suppressed immune system. However, the unbridled T-cell activity disrupts the immune homeostasis and induces a unique spectrum of side effects called immune-related adverse events (irAEs) in a significant proportion of patients. These irAEs are distinct from the side effects produced by traditional chemotherapeutic agents. Although majority of irAEs are manageable with corticosteroids and other immunosuppressive agents, life-threatening and fatal events have been reported. In the absence of predictive biomarkers to identify patients at risk for irAEs and standardized approach to detect, report, and treat irAEs, management of irAEs has been challenging to the patients, caregivers and the healthcare providers alike. With increasing use of ICPis for treatment of various cancers, the incidence of irAEs will undoubtedly increase. There is a compelling need to develop measures to effectively manage irAEs, both in the community settings and in cancer centers alike. To this end, in this paper, we propose several strategies, such as providing patient education, harmonizing irAE management guidelines, standardizing reporting of irAEs, optimizing the choice of immunosuppressive agents, conducting preclinical, clinical and translational studies to better understand irAEs, including high-risk patients, incorporating diagnostic tools to personalize irAE management using wireless technology and digital health, providing a platform to hear the missing patient’s voice, and sharing evolving data to improve the management of irAEs.

Side-Effects of Monoclonal Antibody Infusions for the Diagnosis and Treatment of Cancer

1988 ◽  
Vol 3 (3) ◽  
pp. 147-153 ◽  
Author(s):  
E.F.H. van der Linden ◽  
M.J.P.G. van Kroonenburgh ◽  
E.K.J. Pauwels
Keyword(s):  
Monoclonal Antibody ◽  
Monoclonal Antibodies ◽  
Side Effects ◽  
Diagnosis And Treatment ◽  
Target Cells ◽  
Clinical Use ◽  
Skin Reactions ◽  
Discontinuation Of Treatment ◽  
Diagnostic Applications ◽  
Toxic Reactions

This literature review presents an inventory of the nature and incidence of side-effects that arise from the clinical application of monoclonal antibodies (MoAb) for the diagnosis and treatment of cancer. Most side-effects occurred during therapy. Toxic reactions, such as fever, sweating and chills, were more common than immunological skin reactions; they were observed predominantly in association with the elimination of circulating target cells. Dosage and rate of administration of the MoAb appeared to have little influence on the reactions, which disappeared quickly and did not necessitate discontinuation of treatment. Serum sickness, anaphylactic reactions and bronchospasms were not common; the patients reacted quickly to the indicated therapy. Prevention of the side-effects described here, especially during diagnostic applications, was such that they need not form a barrier to the clinical use of MoAb.

scholarly journals Concentrations of Thyroid Axis Hormones in Psychotic Patients on Hospital Admission: the Effects of Prior Drug Use

Medicina ◽  
2012 ◽  
Vol 48 (5) ◽  
pp. 33 ◽  
Author(s):  
Vesta Steiblienė ◽  
Narseta Mickuvienė ◽  
Arthur Prange ◽  
Robertas Bunevičius
Keyword(s):  
Drug Use ◽  
Hospital Admission ◽  
Rating Scale ◽  
Venous Blood ◽  
Significant Proportion ◽  
Sex Hormone Binding Globulin ◽  
Antipsychotic Treatment ◽  
Thyroid Disorder ◽  
General Group ◽  
Thyroid Axis

The aim of this study was to determine the concentrations of thyroid axis hormones in psychotic patients on hospital admission and to search for the associations between the concentrations of these hormones and prior drug use as well as mental symptoms. Material and Methods. Psychiatric diagnoses, psychotropic drug use, and the severity of psychoses were evaluated using the standard methods on admission. Venous blood from patients and healthy controls was drawn for the analysis of free thyroxin (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), and sex hormone-binding globulin (SHBG) concentrations. Results. Eighty-one psychotic patients, free of a thyroid disorder, were enrolled into the study. Compared with the controls, they displayed the higher FT4 concentrations in the general group (P=0.003) and the higher SHBG concentrations only in men (P=0.013). The FT4 concentration was higher in the patients who were not taking an antipsychotic drug on admission (P=0.039). No significant correlation was found between the severity of psychosis and concentrations of thyroid axis hormones. However, the FT3 concentration in the general group and TSH concentration in women correlated with the factor of the Brief Psychiatric Rating Scale expressing elevated mood. Conclusions. Our study confirms the higher FT4 concentrations in a significant proportion of acute psychotic patients. The concentrations of thyroid axis hormones were found to be associated with prior antipsychotic treatment on hospital admission.

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